Exam 1 Flashcards
1
Q
- Benzodiazepine Prototype and suffix
- Benzodiazepine indications
- Action
- Contra
- Adverse effects
- Interactions
- Antedote
A
- Diazepam (“pam” drugs)
- anxiety, alcohol withdrawal, seizure control,
- Makes GABA more effective
- Preggo, drunk, glaucoma, coma, shock, psychosis
- hypotension, confusion, dry mouth, constipation, nausea, vomiting, blurred vision, urinary retention
- alcohol. Increased effect w/ cimetidine, contraceptives, disulfuram. Decreased effect with theophylline or pepcid
- Flumazenil (Romazicon)
2
Q
- Barbituate/Sedative Prototype and suffix:
- indications
- Action
- Contra
- Adverse effects
- Interactions
- which population gets unpredictable on these?
A
- Phenobarbital (“cet” and “al”)
- anxiety, sedation, seizure, insomnia, pre-anesthesia
- cns depressant
- preggo, liver, kidney, respiratory distress, porphyria
- CNS (means resp dep), dependency, ataxia, nausea, vomit, constipation
- anticoagulants, digoxin, tricyclics, corticosteroids, contraceptives, phenytoin
- Peds
3
Q
- Hypnotic Prototype
- indications
- Action
- Adverse effects
- Name a couple other anxiolytic/hypnotic drugs:
- Name the anxiolytic drug that is less addictive, has less side effects, and doesn’t depress CNS:
A
- Ambien
- insomnia
- works on reticular activating system
- sleep walking, amnesia
- Promethazine (phenergan) and Benadryl
- Buspirone (BuSpar)
4
Q
- What is depression a result of?
- Name the neurotransmitters dealing with mood?
- Recite the 3 ways (generally speaking) antidepressants work:
- What are the classifications (4) of antidepressants?
A
- a deficiency of one or more neurotransmitters
- Dopamine, norepinephrine, and serotonin
- Inhibits MAO, blocks reuptake of neurotransmitter, regulation of receptors and breakdown of neurotransmitters. All lead to increased neurotransmitters in the synaptic cleft.
- tricyclics, MAOIs, and SSRIs
5
Q
- Prototype tricyclic:
- action
- Other than depression, what are some indications?
- contra:
- adverse:
- interactions:
- Assessment:
A
- imipramine (amitriptyline is another)
- inhibits reuptake of serotonin and norepinephrine
- used in patients w/ sleep disorders, enuresis in kids, chronic pain
- recent MI, preggo/lactation, myelography
- Sedation
dry mouth
constipation - MAOIs, anticoagulatnts
- recent suicide attempts, plans, thoughts, sleep, affect and energy
6
Q
- what does MAO do? So what is the action of MAOIs?
- What is Mar-Nar-Par?
- Indications of MAOIs:
- What dietary issue makes it hard for patients on MAOIs?
- adverse:
- interactions:
A
- breaks down neurotransmitters in brain. MAOIs inhibit MAO. Thus no breakdown of neurotransmitters = happy
- A combo of 3 MAOIs that work on those who didn’t respond to newer, safer antidepressants (Marplan, Nardil, Parnate). Used for reactive depression.
- Treatment of patients with depression who are unresponsive to, or unable to take other antidepression agents. These suck to be on!
- Inhibit breakdown of Tyramines leading to hypertensive crisis.
- agitation, hyperreflexia, GI issues, weight gain, dry mouth, hepatotoxic
- other antidepressants, methyldopa, INSULIN! Doesn’t play well. NPM (no popular meds)
7
Q
- SSRI prototype and benefit of this class:
- Action:
- Indications:
- adverse:
- What happens of too much serotonin?
- what is the black box warning on SSRIs?
A
- Prozac (fluoxetine “ine” and “pram” drugs). Has less adverse effects than other antidepressants
- blocks reuptake of serotonin, no effect on norepi.
- in addition to depression, PMDD, anxiety, phobias etc.
- insomnia, CNS effects, GI, GU, sexual dysfunction
- serotonin syndrome: can be fatal. Fever, agitation, tremors, sweating, diarrhea , seizures, coma, dysrhthmia
- suicide especially in youth
8
Q
- Name a few misc. antidepressants:
- which of these is used for smoking cessation?
- What are the benefits of Wellbutrin/Zyban?
- Who is it contraindicated for?
A
1. Bupropion (Wellbutrin, Zyban) Mirtazapine (Remeron) Nefazodone (Serzone) Trazodone (Desyrel) Venlafaxine (Effexor)
- Bupropion (Wellbutrin, Zyban)
- no sexual side effects and no weight gain.
- seizures
9
Q
- Do psychotherapeutic drugs cure disorders?
- What issues are treated with these drugs?
- What is another name for antipsychotic drugs?
- Most antipsychotic drugs are ………….. ………… ………….. .
- Why is poor compliance common with these drugs?
- What are the main side effects?
- What are extrapyrimidal symptoms and how can you treat?
A
- No. they just help to be able to live semi-normal
- schizo, mania/bipolar, ADHD/ADD
- neuroleptics or tranquilizers
- dopamine receptor blockers
- because the side effects and stigma.
6. hypotension anticholinergic effects sedation weight gain sexual side effects “fogginess” extrapyramidal effects (EPS)
- pseudoparkinsonism, akathesia (pacing restless), acute dystonia (grimacing, eye rolling), Tardive dyskinesia (dude in video).
Treat with benedryl or benztropine
10
Q
- Prototype ATYPICAL antipsychotics
- Indication:
- What is the life threatening adverse effect
A
- clozaril (clozapine)
- schizophrenia who are unresponsive to standard drugs
- neuroleptic malignant syndrome (characterized by encephalopathy [anything related to decreased brain function] ).
11
Q
- prototype TYPICAL antipsychotic:
A
- Chlorpromazine (thorazine)
12
Q
- prototype bipolar medication
- action:
- T or F, is it important to monitor Litium levels? Why? What is normal? What else should be assessed?
- Adverse:
- contra:
- Interactions:
A
- Lithium
- alters sodium transport in nerves and muscle cells, inhibiting dopamine and norepi
- T. Can be toxic. Normal = 0.6 - 1.2. Assess urinary output, liver/renal
- pregnancy
- renal or cv disease, dehydration, Na+ depletion, use of diuretics
- hydrochlorthiazide, haloperidol, carbamazepine
13
Q
- Prototype Dopaminergic:
- Indication
- Action
- Adverse:
- side effects:
- Contra:
- Interactions
- why does carbidopa help?
A
- Levodopa/carbidopa (sinemet)
- s/s of parkinsons helping movement be more normal.
- increases dopamine in substantia nigra
- arrhythmias (most important) anxiety, nervousness, headache, blurred vision
- confusion, dysphagia (very bad), grinding of teeth, clumsiness
- pregnancy, glaucoma, urinary of GI obstruction, PROSTATIC HYPERPLASIA (BPH)… may need suprapubic catheter.
- MAOIs (increases levodopa), B6 (cancels levodopa),
- slows metabolism of levodopa
14
Q
- what is parkinsons
- progression:
- does it cause pain or problems with thinking?
- What is the hallmark of Parkinsons?
A
- progressive nervous system disease that destroys dopamine secreting cells
2. Ataxia Bradykinesia Lack of Coordination Rhythmic Tremors Rigidity/Weakness Trouble Maintaining Position or Posture Difficulty Walking Drooling and Affected Speech Mask-like Expressions
- no
- bradykinesia
15
Q
- What are the 2 anticholinergics for Parkinsons?
A
- Benzotropine (congentin) and benedryl